While North Americans
parents may stop to think about whether their children are getting enough
calcium or iron or vitamin C – most don’t think twice about their iodine
intake.Fortunately, they don’t really
need to.

The widespread availability of iodized salt, fortified cereals
and other fortified food products means that most North American children find
more than enough iodine in their daily diets.Unfortunately that is not the case for just under 1/3 of the world’s
children who live in parts of the world where iodine deficiency is common.

Why do we need iodine?
Iodine is essential for proper functioning of the thyroid gland.The thyroid produces hormones that are essential
in all stages of the lifecycle – but particularly to the physical and mental
development of children. Severe iodine deficiency in utero and during early
childhood is associated with dwarfism and cretinism.Moderate iodine deficiency is one of the
world’s leading causes of mental impairment - associated with an average loss
of 10-15 IQ points.The cumulative
effect on the educational achievement and work productivity of entire
communities is staggering.

Where do we get
iodine? Iodine comes primarily from our food and water supplies. The oceans
have a naturally high iodine content and so seafood and sea salt are very good
sources of iodine.In contrast, the
iodine content of land-based plants and animals varies greatly based on the
quality of soil in the region where they are grown.Widespread flooding and erosion has caused
much of the world’s soil to be deficient in iodine. It’s particularly bad in high mountains like
the Himalayas, Andes and Alps
and places with frequent flooding like Bangladesh
and India.

What can be done?The most common way to improve iodine intake
at the population level is through fortification of table salt with
iodine.(According to the International Council for the Control of
Iodine Disorders, about 50% of US salt sold is iodized compared to100% of
Canadian table salt).This simple and
inexpensive method (estimated to cost 10 cents per person per year) requires
that salt be processed in central locations and that there is good
transportation infrastructure to make it available in markets and supermarkets.
Other food products like soy sauce, flour and breakfast cereal are also fortified
in certain countries. The iodine content of soil can be improved through adding
iodine to irrigation water or with fertilizer.

What can you do?Be informed and be an advocate!According to the Network for Sustained Elimination of Iodine
Deficiency, 20 years of efforts have expanded coverage for iodized salt to
70% of the world’s population.Reaching
the last 30% is critical.Read this recent New
York Times op-ed by columnist Nicolas Kristof “Raising the World’s IQ” .Consider supporting the works of
organizations such as Kiwanis
International and UNICEF who promote
salt iodization and address other early childhood nutrition issues.

Peanut butter has gotten a bit of a bad name in recent years. The apparent rise in the percent of North American children with potentially deadly peanut allergies (estimated at about 1% of all US children) has led to the banning of peanut products from airplanes and elementary school classrooms. Do you know though, that in some corners of the world peanut butter is actually saving the lives of small children as young as 6 months old?

Plumpy'nut is a specially formulated peanut paste made from peanuts, oil, sugar, dried milk powder and a mix of vitamins and minerals It contains nearly 4,000 calories per kilogram - which translates into about 60 calories per tablespoon. Plumpy'nut was developed in 1999 in France by the company Nutriset for use in emergency famine situations where large numbers of severely malnourished children need to be rehabilitated. Its high nutrient density and sweet milky taste are perfect for ensuring that children with small stomachs and depressed appetites can still get the carbohydrates, fat, protein, vitamins and minerals that they desperately need.

Before Plumpy'nut, the rehabilitation of a severely malnourished child required daily visits to feeding centers or ongoing hospitalization over a period of months in order to feed them special therapeutic milks. In contrast, several weeks worth of Plumpy'nut can be sent home with the malnourished child's caregiver. It is ready to eat right out of the package and does not require refrigeration. Most children over 1 year old, can actually feed themselves the soft paste and can be rehabilitated in as few as 2 to 4 weeks.

The peanut butter paste is relatively simple to produce. Peanuts are an ideal base because they have a high energy and protein content but do not require a lot of processing in order to be digestable. Versions of the paste have also been developed that replace peanuts with soybeans or chickpeas.

Meds and Food for Kids is a non-profit organization in northern Haiti that was started by a pediatrician from the Washington University of St. Louis School of Medicine. Meds and Foods for Kids is locally producing Medika Manba ("peanut butter medicine" in Haitian Creole) using a very similar formulation to the original Plumpy'nut. In addition to distributing the Medika Manba through mobile clinics, they work with local farmers to improve their peanut farming and storage practices. They have modeled their work on Project Peanut Butter, a non-profit started in Malawi that is using locally produced peanut paste to treat and prevent malnutrition in rural Malawi and more recently in Sierra Leone.

Jamaica is home to may of the world's best sprinters. Kenyans run faster marathons. The Chinese team won all four gold medals in synchronized diving. Watching the 2008 Olympics you can not help but notice that athletes from certain corners of the world tend to dominate certain events.

What about child growth and development? Do children in certain parts of the world naturally grow faster during early childhood? The answer seems to be "no." Given access to the same good feeding practices, quality medical care, and other environmental conditions, children all over the world grow and develop at about the same rate from birth to age 5.

The new reference is based on findings from a study carried out between 1997 and 2003 that followed the growth and motor development milestones of more than 8500 children from 5 different countries and continents (Brazil, Ghana, India, Norway, Oman and the USA).

In each country they only included first-born, full-term infants of non-smoking mothers. Mothers in the study agreed to follow WHO recommendation to exclusively breastfeed the infants until age 6 months and to continue breastfeeding until age 2 years. They did not select families with poor economic status, history of health problems or other environmental constraints that might affect the child's growth.

So wherever you live, providing nutritious foods and a healthy environment for your children promotes normal development and enables each child to reach her natural potential. Who knows? She might even make an Olympic appearance one day!

About

Rebecca HeidkampRebecca Heidkamp is PhD candidate in Nutrition at Cornell University. She is currently working in Port-au-Prince, Haiti where she focuses on improving infant feeding practices among children ages 6-12 months old who are born to HIV-infected mothers. She has worked with mothers and children in Honduras, Kenya, Rwanda, Mozambique, Haiti and the United States. Cookbooks are her favorite form of bedtime reading but her cookbook collection is getting a little too large to travel with her.